Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer

Abstract

Background/AimsMini-probe endoscopic ultrasonography (mEUS) is a useful diagnostic tool for accurate assessment of tumor invasion. The aim of this study was to estimate the accuracy of mEUS in patients with early colorectal cancer (ECC).MethodsNinety lesions of ECC underwent mEUS for pre-treatment staging. We divided the lesions into either the mucosal group or the submucosal group according to the mEUS findings. The histological results of the specimens were compared with the mEUS findings.ResultsThe overall accuracy for assessing the depth of tumor invasion (T stage) was 84.4% (76/90). The accuracy of mEUS was significantly lower for submucosal lesions compared to mucosal lesions (p=0.003) and it was lower for large tumors (≥2 cm) (p=0.034). The odds ratios of large tumors and submucosal tumors affecting the accuracy of T staging were 3.46 (95% confidence interval [CI], 1.05 to 11.39) and 6.25 (95% CI, 1.85 to 25.14), respectively. When submucosal tumors were combined with large size, the odds ratio was 14.67 (95% CI, 1.46 to 146.96).ConclusionsThe overall accuracy of T stage determination with mEUS was considerably high in patients with ECC; however, the accuracy decreased when tumor size was >2 cm or the tumor had invaded the submucosal layer.

3D echoendoscopy and miniprobes for rectal cancer staging

“…2) for T1 staging, which is in agreement with previous reports (21,22). With regard to T2 staging, 3D was superior to mp-EUS, which tended to overstage tumors (12,16,17,(22)(23)(24).…”

“…Miniprobe EUS (mp-EUS) may easily overcome these obstacles due to its reduced diameter and flexibility (8,9). mp-EUS may be the most adequate ultrasonographic tool for the differential diagnosis of tumors limited to the mucosa (T1m) or with involvement of the submucosa (T1sm) as it uses high frequencies and thus resolves the limitations of C-EUS (10,11).…”

Miniprobe Endoscopic Sonography for Gastrointestinal Tract Assessment: A Case Series of 1451 Procedures

“…They found that miniprobe endoscopic sonography had high accuracy in determining the depth of colorectal lesions and was useful before endoscopic resection. However, miniprobe endoscopic sonography has limitations in determining the tumor stage in early colorectal cancer, and the accuracy decreased when the tumor size was greater than 2 cm or the tumor had invaded the submucosal layer (Table ) …”

Brief Education on Microvasculature and Pit Pattern for Trainees Significantly Improves Estimation of the Invasion Depth of Colorectal Tumors

“…Several studies have reported the usefulness of endoscopic ultrasonography (EUS) for estimating the invasion depth [ 15 – 18 ]. However, the echoendoscope can be applied only to distal colorectal lesions, and the use of a miniprobe may be limited due to the probe's insufficient penetration depth for the estimation of large protruded tumors [ 19 ].…”